HomeMy WebLinkAboutH2021-0271 - PermitsCity of Newport Beach - Building Division III 111111111111111111111111111111111111111111111
100 Civic Center Drive, Newport Beach, CA 92660 H 2 0 2 1 0 2 7 1
u n Permit Counter Phone (949)644-3288
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Job Address: 2200 VISTA DORADO BldgA Floor: Suite:
Description of Work: MECH/ A/C & FAU C/O "TAMPER RESISTANT CAP REQ"
InspectorArea:4 Code Edit: 2019
Legal Description: TR 5741 (L.L.84-214029) PAR 19
Owner: CA RYAN&JACKIE Contractor:
Address: 00 VISTA DORADO Address:
NEWPORT BEACH CA 92660
Phone:
Issued
Processed
Phone:
Con State Lic:
Lic Expire:
Bus Lic:
Lic Exp Date:
AIRWEST A/C & HEATING INC
1886 SO SANTA CRUZ ST
ANAHEIM CA 92805
714-978-7877
733715
03/31/2023
BT30072921
09/30/2021
MECHANICAL Permit: H2O21-0271
Project No:
Inspection Requests Phone (949)644-3255
M-PECTOF-1
°
Worker's Comp Insurance- ..°. ..�bc
Carrier: BENCHMARK .... °
Policy No: CST5020526
Expire:11/14/2021 ` .°
°
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LdF[LLDINSPI',E'' `•`°°
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icl,,,ijE V AND APP(VQV m ,
AC Items
FEES
maces Boilers & Compressors
Ventilation
Other
to 100K BTU/hr:
1
$21.00
Up to 3HP:
0 $0.00
Bathroom Fan:
0 $0.00
Fire Dampers:
0 $0.00
$0.00
er 100K BTU/hr:
0
$0.00
> 3 HP to 15 HP:
0 $0.00
Exhaust Fan:
0 $0.00
Gas Line:
0 $0.00
$0.00
ill/Floor Heaters:
0
$0.00
>15 HP to 30 HP:
0 $0.00
Attic Fan:
0 $0.00
Metal Fireplace:
0 $0.00
at Pumps & Package
Units
>30 HP to 50 HP
0 $0.00
Down -Draft Fan:
0 $0.00
Record Mgt Fee:
$0.00
to 100K BTU/hr:
1
$21.00
>50 HP:
0 $0.00
Residential Hood:
0 $0.00
Additional Fee:
$18.27
Investigation:
$0.00
;r 500K BTU/hr:
0
$0.00
Air Handling Units
Comm. Hood:
0 $0.00
Plan Check:
$0.00
to 1 M BTU/hr:
0
$0.00
up to 1OK CFM:
0 $0.00
Repair/Alter/Add:
0 $0.00
Model:
GSZ16-0421BIssuance:
$37.00
to 1.75M BTU/hr:
0
$0.00
Over 10K CFM:
0 $0.00
Supplemental Fee:
$0.00
Manufacturer:
GOODMAN
;r 1.75M BTU/hr:
0
$0.00
VAV Box:
0 $0.00
Zoning PC:
$46.25
TOTAL: $143.52 Plan Check Fee: $0.00 Fee Due at Permit Issuance: $143.52
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
Construction Hours: Monday - Friday 7:00 a.m.to 6:30 p.m.and Saturday from 8:00 a.m, to 6:00 p.m.
4 ;•
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the reason(s) indicated below by the checkmark(s) I have placed next to the applicable item(s)
(Section 7031.5, Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for
the permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and
Professions Code) or that he or she is exempt from licensure and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penally of
not more than five hundred dollars ($500).
❑ I, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or U portions of the work, and the structure is not intended or offered for sale (Section 7044,
Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through employees' or personal effort, builds or improves the property, provided that the
improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the Owner -Builder will have the burden of proving that it was not built or
improved for the purpose of sale).
❑ I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' State License Law does not
apply to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law).
❑ 1 am exempt from licensure under the Contractors' State License Law for the following reason:
By my signature betWl acknowledge that, except for my personal residence in which I must have resided for at least one year prior to completion of the improvements covered by this permit, I cannot legall7
sell a structure that4 have built as an owner -builder if it has not been constructed in its entirety by licensed contractors. I understand that a copy of the applicable law, Section 7044 of the Business and
FtQfe96idns Code, "vailable upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html.
Stgnaturt of Propegf QVner or Authorized Agent Date,,
g6fNIS€D CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Profess ns C It , a d my license is in full force
and effect.
Ljceh6e.Class '��'�U License No Date Z1'-2Contractor Signature _
VI QPYZRS' coURriMSATION DECLARATION
N{k9I2IN y1WLURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER T CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
le•sbs
�reby ®•ffirm underpeKally of perjury one of the following declarations: -
J We and wifl lnalrtain a certificate of consent to self -insure for workers' compensation, issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for th
30rforrgance of thl kvprkfor which this permit is issued. Policy No.
WIha__v`` and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensatioi
nsura ce carrier and policy number are: f //
�rxel_%JL�i/Cfi.__Policy Number C.�'?°�L�2ha�2�+ Expiration Date AIZI/2�
Vame of Agent Phone #
JI certify that, in the performance f the rk or which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agre
:hat, if I should become subject to t e wor s' ompensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
Signature of Applicant
DECLARATION REGA DING C STRUCTION LENDIN
hereby affirm under p nalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code).
ender's Name Lender's Address
3y my signature below, I certify to each of the following:
I am the property owner or authorized to act on the property owner's behalf.
I have read this application and the information I have provided is correct.
I agree to comply with all applicable city and county ordinances and state laws relating to building construction.
I authorize representatives of this city or county to en},th1e above -identified property for inspection purposes.
Signature of Property Owner or Authorized Agent l .1��i4/Y� JgkL;T'Zk�'n Print Property Owner's or Authorized Agent's Name,
AC71ON
DATE
8Y
DECLARATION OF COMPUANCE WITH CODE OF
FOR OFFICE USE ONLY
FEDERAL REGULATIONS PART 61 OF T17LE40 AND
AQMD RULE 1403
PERMIT EXPIRED
❑ ISUBMITTEDASBESTOS NORFICATION TO:
❑ EPA
❑ AQMO
PERMIT CANCELLED
PERMIT EXTENDED
❑ ASBESTOS NOIIRCA710NIS NOT APPLICABLE TO
PROPOSEODEMOLITION.
PERMIT FINAL
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CERTIFICATEOF
SIGNATURE:
OCCUPANCYISSUED
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